Background: Over the last few decades there has been a change in the trend of antibiotic sensitivity of Salmonella typhi from being sensitive to first line drugs like chloramphenicol, ampicillin and cotrimoxazole to developing multi-drug resistance. Most strains are presently sensitive to third generation cephalosporins and azithromycin but are developing resistance against fluoroquinolones. Objectives: To determine the culture positivity and antibiotic sensitivity pattern of Salmonella typhi. Method: This retrospective study was conducted at the Institute of Child Health, Kolkata from July 2014 to December 2020. Nine hundred and twenty children aged 1-10 years were included in the study, all with fever for more than 5 days. These children were suspected to have typhoid fever clinically i.e., with history, suggestive physical examination and after excluding other common febrile illnesses with routine blood test as per hospital protocol. Blood culture was done to confirm the diagnosis of typhoid fever, determine the proportion of blood culture positive cases and to find out the antibiotic susceptibility of Salmonella typhi in our hospital set up. Children were included in the study irrespective of prior antibiotic treatment. Results: Of the 920 children, 55% were male and 45% were female; 15% cases were between 1-2 years of age and 85% were between 2-10 years of age; 53% cases were culture positive. In our study S. typhi was fully sensitive to ampicillin, chloramphenicol, cefixime, ceftriaxone and azithromycin. It was highly sensitive to cotrimoxazole. It was highly resistant to ciprofloxacin and nalidixic acid Conclusions: There was complete sensitivity of Salmonella typhi to third generation cephalosporins and azithromycin. It was also sensitive to older, less commonly used antibiotics like chloramphenicol, cotrimoxazole and ampicillin. There was increased resistance to fluroquinolones. Sri Lanka Journal of Child Health, 2023: 52(2): 169-174

Introduction: Mid-aortic syndrome (MAs), coarctation of abdominal aorta is a rare disease with only 200 reported cases. It is characterized by constriction of distal thoracic and/or abdominal aorta and its branches, therefore is also known as abdominal aortic coarctation. the MAs is characterized radiologically by severe narrowing of abdominal aorta and its branches and most of these patients usually die due to progressive severe hypertension before the age of 35-40 if left untreated. case report: A 13-year-old boy was admitted with persistent headache and vomiting for one month and repeated generalized tonic clonic seizures for two days. His past history was unremarkable. the highlight of the clinical examination blood pressure was 240/150 mmHg in both the upper limbs, and all peripheral pulses were palpable. blood pressure was similar in upper and lower limbs and a systolic bruit heard over the epigastrium. Ultrasonography showed a localized narrowing of a suprarenal segment

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